You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 20121455 EARLY REPEAT BIOPSY AS A PART OF AN ACTIVE SURVEILLANCE PROTOCOL Ahmed El-Shafei, Ayman Moussa, Ranko Miocinovic, Jianbo Li, Khaled Fareed, Ryan Berglund, Levy David, Andrew Stephenson, and J.Stephen Jones Ahmed El-ShafeiAhmed El-Shafei Cleveland, OH More articles by this author , Ayman MoussaAyman Moussa Cleveland, OH More articles by this author , Ranko MiocinovicRanko Miocinovic Cleveland, OH More articles by this author , Jianbo LiJianbo Li Cleveland, OH More articles by this author , Khaled FareedKhaled Fareed Cleveland, OH More articles by this author , Ryan BerglundRyan Berglund Cleveland, OH More articles by this author , Levy DavidLevy David Cleveland, OH More articles by this author , Andrew StephensonAndrew Stephenson Cleveland, OH More articles by this author , and J.Stephen JonesJ.Stephen Jones Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1949AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Repeat or “re-staging” prostate biopsy is used to identify disease progression in patients with prostate cancer managed with active surveillance. Our aim is to evaluate ability to identify unfavorable pathology on early repeat biopsy for patients considering active surveillance for proper patient selection. METHODS We performed office-based repeat transrectal ultrasound guided biopsy (TRUBP) on all 137 patients who were diagnosed with prostate cancer and were being considered for active surveillance (AS). We performed restaging biopsy within the first 7 months after diagnostic biopsy. All patients were diagnosed using a minimum of 12 cores biopsy. Demographic, clinical & pathological data from both biopsies were reviewed including age, race, family history, total PSA, PSA slope, number of cores obtained, number of positive cores, % of positive cores/number of cores, number of positive cores to total cores, Gleason sum, total gland volume, PSA density, max cancer% per core & clinical stage. Statistical comparison was performed using the Wilcoxon rank sum for continuous variables & McNeMar's Chi-square test for categorical variables. RESULTS Mean age was 65 years; 85% were Caucasian, 13% had positive family history & 92% had stage T1c. Among variables analyzed we found only the mean maximum cancer % per core (20.1% for initial & 27.2 for restaging biopsies) & presence of coexistent atypia or PIN demonstrated statistical significance, while there is no statistical significance found regarding the number of positive cores & Gleason sum (table 1). Table 1. Statistical analysis of different variables Variables P value Number of positive cores 0.0710 Positive cores/number of cores 0.03697⁎ Gleason sum 0.2596 Total volume 0.6394 PSA density 0.6477 Max cancer% 0.0268⁎ (PIN) 0.0012⁎ Atypia 0.0123⁎ ⁎ Statistically significant. CONCLUSIONS Our analysis shows that identification of adverse (unfavorable) pathological findings on restaging biopsy which indicate disease upgrading are maximum cancer % per core & coexistence of PIN or atypia. The number of positive cores on initial biopsy was marginally associated with unfavorable pathology on restaging biopsy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e589-e590 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed El-Shafei Cleveland, OH More articles by this author Ayman Moussa Cleveland, OH More articles by this author Ranko Miocinovic Cleveland, OH More articles by this author Jianbo Li Cleveland, OH More articles by this author Khaled Fareed Cleveland, OH More articles by this author Ryan Berglund Cleveland, OH More articles by this author Levy David Cleveland, OH More articles by this author Andrew Stephenson Cleveland, OH More articles by this author J.Stephen Jones Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...